Friday, 21 February 2014

Dialysis for Pregnant Women with Kidney Failure

A study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN) concludes that intensive dialysis for pregnant women with failing kidneys results in a greater proportion of live births when compared with standard dialysis.

Pregnancy is considered dangerous if the mother-to-be has advanced kidney disease. Dangerous to both the mother and child. The study compared the live birth rate for a group who had received intensive dialysis treatment with the more general cases who had received standard dialysis treatment. With intensive hemodialysis the live birth rate was 86.4% (22 patients) while in the standard treatment group of 70 patients, the live birth rate was 61.4%. This was considered a significant improvement.

Among the findings of this Canadian study were the following:

In patients with established kidney failure at conception, the live birth rate in the group from Toronto was 83%, compared with only 53% in the American group.

The median duration of pregnancy in the more intensively dialyzed group of women from Toronto was 36 weeks compared with 27 weeks in American women.

A dose response between dialysis intensity and pregnancy outcomes occurred. For women dialyzed for more than 36 hours per week, the live birth rate was 85%, while it was only 48% in women dialyzed for 20 hours or less per week. Infants were a healthier weight at birth when women were dialyzed for more than 20 hours per week than when women were dialyzed for 20 hours or less per week.

Complications were few and manageable in women who received intensive dialysis.

“More intensive dialysis has improved pregnancy rates and dramatically improved pregnancy outcomes,” said Dr. Hladunewich, lead scientist in the study. “This study provides hope to young women on dialysis who might want to consider having a family.”


The Journal's online abstract can be found at